Captopril versus frusemide in moderate heart failure.
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Biomedical subjects
Publications and source records attributed to S M Liberatore.
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In 15 patients with moderate congestive heart failure not completely controlled on digoxin (0.25 mg o.d.) and frusemide (25 mg o.d.), we compared the addition of captopril (12.5 to 50 mg b.i.d.) with increasing doses of frusemide (25 to 100 mg o.d.), in a randomized double-blind, double-dummy, comparative trial. Thirteen patients completed the 3 months study: two dropped-out in the frusemide group. Statistically significant clinical improvement occurred in both treatment groups. Exercise tolerance also significantly improved in both groups in a parallel fashion. Echocardiographic cardiac function data showed a significantly better pattern of changes in the captopril group. The addition of low doses of captopril to basal therapy seems to be as effective as the addition of high doses of frusemide in uncontrolled moderate congestive heart failure. This approach with captopril also appears to be more physiological and safe.
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We investigated the behaviour of several indices of ventilation unevenness in a sample of 234 normal subjects aged between 20 and 80 years, divided into 12 classes of 5 years each. The aim of the present study was to find out whether it is possible to predict a reliable value for each of these indices as a function of age, height and TLC. For each index a large dispersion of experimental points and a high unexplained variance was found, so that it does not seem worthwhile predicting its value as a function of age, height and TLC. We concluded that there is no reason to employ these indices to detect the beginning of a lung function impairment.
We studied the respiratory mechanics, acid-base status, alveolar ventilation and ventilatory response to hypercapnia in pregnant women at the first and third trimesters and postpartum. We found alveolar hyperventilation and hypersensitivity of the respiratory centers to carbon dioxide with no significant differences between the first and third trimesters. After delivery we found a sudden decrease in these parameters. The changes seem to be due to a direct primary (probably hormonal) stimulation on the medulla oblongata and cannot be correlated to the metabolic needs of the fetus and are aimed at favoring placental gas exchanges, especially at the beginning of the pregnancy, when the fetal cardiovascular system is not yet developed.
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